This publication presents summary Aboriginal and Torres Strait Islander (Indigenous) results from the 2001 National Health Survey (NHS), conducted by the Australian Bureau of Statistics from February to November 2001. Survey content presented in this publication includes health status measures as well as information relating to health service use and lifestyle factors which affect health. Corresponding information for the non-Indigenous population, and data from the 1995 NHS, have been included for comparative purposes.

For the first time, NHS results are presented for Indigenous Australians living in remote areas. This information is limited to those items for which data are of acceptable quality.

As shown in the graph below, the Indigenous population is considerably younger than the non-Indigenous population. The close relationship between health and age makes it misleading to compare total populations with differing age structures. Comparisons between Indigenous and non-Indigenous Australians are therefore presented by age group or by using age standardised rates to allow for the effect of age.

DATA QUALITY

Sampling error

Due to the small size of the supplementary Indigenous samples in the 1995 and 2001 NHS, the Indigenous results have larger sampling errors than results for the non-Indigenous population. For this reason, differences in results between the Indigenous and non-Indigenous populations, between Indigenous results for 1995 and 2001, and between remote and non-remote Indigenous estimates may or may not be statistically significant. That is, for some of the statistics presented in this publication that may be different for different sub-populations or time periods presented, the size of the associated sampling errors means that it cannot be stated with any confidence that the estimates represent any real difference between the sub-populations or time periods. Significance testing has been undertaken on selected Indigenous and non-Indigenous comparisons (table 1) and on time series data (table 2) presented in this publication to assist readers with understanding the level of significance that should be attributed to apparent differences in rates.

Non-sampling error

There are a number of sources of error in survey results apart from sampling error (the variability between the results that the total population would report and those obtained from a representative sample). The 'reliability of estimates' and 'interpretation of results' sections of the Explanatory Notes to this publication identify a number of factors that affect the quality of the published estimates. Some of these factors affect the 1995 survey results, or the 2001 results, or both. One such factor is a change in survey field procedures used to identify households for enumeration in non-remote areas in the Indigenous supplement to the 2001 NHS. This change affects the representation in the sample of Indigenous children living in households in non-remote areas where no Indigenous adult is usually resident. While it is unlikely that the change in field procedures impacts on estimates sufficiently to affect the interpretation of the results, readers should be aware of the issue and refer to paragraphs 30 to 32 of the Explanatory Notes for details.

It should also be noted that all results presented in this publication are based on information reported by respondents and may therefore differ from information collected using other methods or sources.

HEALTH STATUS

Self-assessed health

Self-assessed health status provides an indicator of overall health, based on an individual's perception of their health. It should be remembered that this measure is dependent on an individual's awareness and expectation of their own health. As such, it may be influenced by factors such as access to health services and health information.

After adjusting for differences in age structure, two-thirds of Indigenous Australians reported their health as good, very good, or excellent. However, one-third reported their health as 'fair or poor', almost twice the rate for non-Indigenous people (18%) (table 1).

The proportion of Indigenous Australians reporting 'fair or poor' health increased with age, from 13% of those aged 15 to 24 years to 52% of those aged 55 years and over (table 5). Indigenous females were more likely overall to report 'fair or poor' health than Indigenous males (29% compared to 23%).

Long-term health conditions

After adjusting for age differences, Indigenous and non-Indigenous Australians were equally likely (78%) to report having at least one long-term health condition. Indigenous Australians living in remote areas were more likely to report having no long-term health condition (29%) than Indigenous Australians living in non-remote areas (20%) (table 1).

Reporting a long-term health condition increased markedly with age, from 34% of Indigenous children aged under 5 years to 99% of Indigenous Australians aged 55 years and over. The number of reported long-term conditions also increased with age, with three or more conditions being reported by 3% of children aged under 5 years compared with 75% for Indigenous Australians aged 55 years and over (table 3).

Of the selected long-term health conditions presented in Appendix 1, eye/sight problems were the most commonly reported conditions among the Indigenous population (29%). These were followed by asthma (16%), the broad group of back problems (15%) and ear/hearing problems (15%).

Asthma

After adjusting for age differences, Indigenous Australians were more likely to report asthma as a long-term health condition than were the non-Indigenous population(17% and 12% respectively). Although table 1 shows asthma more often reported in non-remote areas than in remote areas, it cannot be stated with any confidence that these estimates represent any real difference between the two sub-populations. Within the Indigenous population, the prevalence of asthma was above 10% across age groups, peaking at 21% for those aged 55 years and over (table 3).

Conditions of the circulatory system

About one-tenth of Aboriginals and Torres Strait Islanders reported a long-term health condition associated with the circulatory system, such as heart disease, hypertension or other conditions affecting the veins or arteries (Appendix 1). After adjusting for age differences between Indigenous and non-Indigenous Australians, nearly one-fifth (19%) of Indigenous Australians reported these conditions (table 1).

Of Indigenous Australians aged 35 to 44 years, 16% reported a long-term health condition associated with the circulatory system. The rate increased to 31% for Indigenous adults aged 45 to 54 years, and to 47% of those aged 55 years and over (table 3).

Among Indigenous Australians, the most commonly reported condition of the circulatory system was hypertension. As shown in the graph below, the prevalence of hypertension increased rapidly among Indigenous Australians from the age of 35 years, with the onset approximately 10 years younger than for the non-Indigenous population.

Diabetes

Diabetes was a reported condition for 5% of Indigenous Australians (Appendix 1). After adjusting for age differences, Indigenous Australians were over three times as likely as the non-Indigenous population to report some form of diabetes, with the condition almost twice as prevalent among Indigenous Australians in remote (16%) compared with non-remote (9%) areas (table 1). As shown below, diabetes increased markedly with age, from 1% of Indigenous persons aged 15 to 24 years to 29% of those aged 55 years and over. As with hypertension, substantial increases in the proportion of the Indigenous population reporting diabetes occurred at a much younger age (35 to 44 years) than for the non-Indigenous population (55 years and over).

HEALTH-RELATED ACTIONS

After adjusting for age differences, in 2001 Indigenous Australians were more likely (53%) to have taken at least one of the listed health-related actions than were non-Indigenous people (47%) (table 7). Indigenous women were more likely (58%) to have taken a health-related action than Indigenous men (47%) (table 10).

Consultations with health professionals

Information collected relating to consultations with health professionals in the two weeks prior to interview suggests some differences between the use of services by Indigenous and non-Indigenous Australians. In 2001, after adjusting for age differences, Indigenous Australians were twice as likely to have visited the casualty or outpatient departments of a hospital in the two weeks prior to interview. However, it cannot be stated with any confidence that there is any difference between Indigenous and non-Indigenous Australians in their likelihood to have consulted either a dentist or a doctor (including general practitioners and specialists) (table 7).

As shown below, the proportion of Indigenous Australians consulting health professionals varied with age. Of children aged under 5 years, 24% had consulted a general practitioner or specialist in the two weeks prior to interview. While this rate was lower among older children and younger adults (to age 34 years), it rose again in older age to a peak of 41% among Indigenous Australians aged 55 years and over. Dental consultations were most common amongst Indigenous Australians aged 5 to 14 years (8%), with approximately 5% of those aged 15 years and over consulting a dentist in the two weeks prior to interview (table 9).

Hospital admissions

After adjusting for age differences, Indigenous Australians were more likely than non-Indigenous Australians to have been hospitalised in the 12 months prior to interview (20% and 12% respectively), with Indigenous males and females being equally likely to have been hospitalised (table 10). As shown below, Indigenous Australians were admitted to hospital more often than non-Indigenous people across all age groups. Hospital admissions were most common amongst Indigenous children aged under 5 years and Indigenous adults aged 25 to 34 and 45 to 54 years (each group 23%) (table 9).

HEALTH RISK FACTORS

Smoking

After adjusting for age differences, Indigenous adults aged 18 years and over were twice as likely as non-Indigenous adults to be current smokers (51% and 24% respectively) (table 13). While the age standardised proportion of Indigenous adults in non-remote areas who smoke was estimated at slightly different rates in 1995 and in 2001, it cannot be stated with any confidence that the estimates represent any difference in population in those years (table 2).

As shown in the following graphs, smoking is more common among Indigenous males and females in every age group when compared with the non-Indigenous population.

Alcohol consumption

Alcohol consumption at risky/high risk levels was reported in the survey at 12% and 11% for Indigenous and non-Indigenous Australians respectively, although sample error means that it cannot be stated with any confidence that this represents any difference in the sub-populations. Indigenous adults were less likely (42%) than non-Indigenous adults (62%) to have consumed alcohol in the week prior to interview (table 13). The proportion of the Indigenous population in non-remote areas reporting alcohol consumption at risky or high risk levels has declined slightly from the time of the 1995 survey, although it cannot be stated with any confidence that this represents a decline in consumption levels in the Indigenous population (table 2).

The proportion of Indigenous adults who consumed alcohol at risky or high risk levels was generally higher for males than females and varied across age groups (see graphs below). The highest proportion was recorded for males aged 35 to 44 years at 23% (table 16). However, younger Indigenous males (18 to 24 years) were less likely (6%) than non-Indigenous males in the same age group (14%) to consume alcohol at risky or high risk levels.

Exercise and diet

Due to collection difficulties, information relating to diet and exercise was not collected for Indigenous Australians living in remote areas. In the two weeks prior to interview, the majority (around 70%) of both Indigenous and non-Indigenous adults living in non-remote areas, reported their levels of exercise for recreation, sport or fitness as either sedentary or low (table 1).

After adjusting for age differences, 42% of Aboriginal and Torres Strait Islander adults living in non-remote areas were estimated to have a medium to high fruit intake, in contrast to 52% of the non-Indigenous population. However, 83% of Indigenous Australians were estimated to have a medium to high vegetable intake (77% for the non-Indigenous population) (table 13).

As shown in the graph below, Indigenous Australians living in non-remote areas in every age group, were more likely than non-Indigenous Australians to add salt to their meals after cooking.

Across each age group, Indigenous Australians were also more likely than non-Indigenous people in non-remote areas to usually drink whole (full cream) milk rather than reduced fat alternatives.

Body mass

Self-reported measurements of height and weight were collected and used as the basis for allocating body mass categories for persons aged 15 years and over. Height and weight information could not be obtained for approximately 20% of Indigenous persons and 8% of non-Indigenous persons. After adjusting for age differences and non-response, Indigenous Australians were more likely (61%) to be classified as overweight or obese when compared with non-Indigenous Australians (48%) (table 1). The proportion of both Indigenous and non-Indigenous persons, aged 18 years and over and classified as obese, has increased since 1995 (table 14).

As shown in the following graphs, Indigenous males and females in each age group were more likely to be classified as obese than non-Indigenous Australians in the same groupings.

Immunisation

Information about vaccinations for influenza and pneumonia was collected from persons aged 50 years and over. About half of Indigenous and non-Indigenous Australians had an influenza vaccination in the 12 months prior to the survey, with another 10% or so of both groups having had a vaccination, but not in the last 12 months. In relation to pneumonia, Indigenous Australians (25%) were almost twice as likely to have had a vaccination in the last 5 years than were non-Indigenous Australians (14%), with the proportion of Indigenous people living in remote areas who had been vaccinated (48%) being more than double that in non-remote areas (19%) (table 19).

The majority of Aboriginal and Torres Strait Islander children under 7 years of age living in non-remote areas were fully immunised against diphtheria, tetanus, whooping cough, polio, measles, mumps and rubella, as were non-Indigenous children, However, for haemophilus influenza type B (HIB), the Indigenous rate was 46% compared to the non-Indigenous rate of 73% (table 20).

Breastfeeding

In 2001, three-quarters (77%) of Indigenous children aged under 4 years living in non-remote areas were reported to have been breastfed for at least some period, similar to the proportion of the Indigenous population of this age who were reported to have been breastfed in 1995 (75%) (table 21).

Women's health

Women aged 40 years and over were asked whether they had mammograms and, if so, how frequently. After allowing for age differences, 43% of Indigenous women reported regular mammograms. For pap smear tests, 50% of Indigenous women aged 18 years and over reported regular tests (table 22).